Dimensional Assessment Of Personality Pathology-Basic Questionnaire Research Articles

Differentiating Abnormal, Normal, and Ideal Personality Profiles in Multidimensional Spaces

Abstract: Current dimensional taxonomies of personality disorder (PD) establish that intense traits do not suffice to diagnose a disorder, and additional constructs reflecting dysfunction are required. However, traits appear able to predict maladaptation by themselves, which might avoid duplications and simplify diagnosis. On the other hand, if trait-based diagnoses are feasible, it is the whole personality profile that should be considered, rather than individual traits. This takes us into multidimensional spaces, which have their own particular – but poorly understood – logic. The present study examines how profile-level differences between normal and disordered subjects can be used for diagnosis. The Dimensional Assessment of Personality Pathology – Basic Questionnaire (DAPP-BQ) and the Personality Inventory for DSM-5 (PID-5) were administered to a community and a clinical sample each (total n = 1,925 and 3,543 respectively). Intense traits proved to be common in the general population, so empirically-based thresholds are indispensable not to take as abnormal what is at most unideal. Profile-level parameters such as Euclidean and Mahalanobis distances outperformed individual traits in predicting mental problems and equaled the performance of published measures of dysfunction or severity. Personality profiles can play a more central role in identifying disorders than is currently acknowledged, provided that adequate metrics are used.

A third hierarchical level of narrower traits for the Dimensional Assessment of Personality Pathology-Basic Questionnaire.

Current dimensional taxonomies of personality disorder show a stronger empirical grounding than categories, but may lack the necessary level of detail to make accurate predictions and case formulations. We need to further develop the lower levels of the hierarchy until reaching the building blocks of personality pathology. The Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) is well-suited to this purpose due to its multilayered structure and its agreement with the official dimensional classifications. We disaggregated the 18 DAPP-BQ mid-level facets through exploratory and confirmatory factor analysis in a sample of 3233 community subjects and outpatients. We obtained a set of 72 clinically relevant, narrower subfacets, which were reliable, well-fitted to the data, and invariant between clinical and community subjects and between the sexes. This third level of abstraction increases by 4.7% the capacity to predict DSM categorical personality disorders, gives a particular advantage in capturing dependent, histrionic, paranoid, obsessive, and schizoid features and can provide the detailed information that clinical decisions demand.

Assessment of Pathological Traits in DSM-5 Personality Disorders By the DAPP-BQ: How Do These Traits Relate to the Six Personality Disorder Types of the Alternative Model?

The six personality disorder (PD) types in DSM-5 section III are intended to resemble their DSM-IV/DSM-5 section II PD counterparts, but are now described by the level of personality functioning (criterion A) and an assigned trait profile (criterion B). However, concerns have been raised about the validity of these PD types. The present study examined the continuity between the DSM-IV/DSM-5 section II PDs and the corresponding trait profiles of the six DSM-5 section III PDs in a sample of 350 Dutch psychiatric patients. Facets of the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) were presumed as representations (proxies) of the DSM-5 section III traits. Correlational patterns between the DAPP-BQ and the six PDs were consistent with previous research between DAPP-BQ and DSM-IV PDs. Moreover, DAPP-BQ proxies were able to predict the six selected PDs. However, the assigned trait profile for each PD didn't fully match the corresponding PD.

Personality dimensions in schizophrenia: A family study

Studies have demonstrated that personality traits differ in schizophrenia patients and family members compared to controls, suggesting familial risk. This study evaluated personality traits in a family study of schizophrenia, as well as the relationship between personality traits and symptoms and social functioning in schizophrenia patients. Thirty-two schizophrenia patients, 28 adult non-psychotic relatives, and 27 community controls completed the Dimensional Assessment of Personality Pathology–Basic Questionnaire (DAPP-BQ). Schizophrenia patients differed on many dimensions of the DAPP-BQ compared to controls and/or relatives: affective lability, anxiousness, callousness, conduct problems, cognitive dysregulation, identity problem, intimacy, insecure attachment, low affiliation, narcissism, oppositionality, restricted expression, self-harm, submissiveness, and suspiciousness. No differences were found between relatives and controls. Furthermore, in schizophrenia patients, associations were found between personality and particularly general symptoms, as well as social functioning. Personality traits can be conceptualized as an extended phenotype in schizophrenia patients.

P.2.b.045 Efficacy of 3 agomelatine dose regimens versus placebo on the core symptoms of depression and functioning

Patients with personality disorders such as the histrionic type exaggerate their responses when receiving external social or environmental stimuli. We speculated that they might also show an augmenting pattern of the auditory evoked potential N1–P2 component in response to stimuli with increasing levels of intensity, a response pattern that is thought to be inversely correlated with cerebral serotonin (5-HT) activity. To test this hypothesis, we collected auditory evoked potentials in 191 patients with personality disorders (19 patients with the paranoid type, 12 schizoid, 14 schizotypal, 18 antisocial, 15 borderline, 13 histrionic, 17 narcissistic, 25 avoidant, 30 dependent and 28 obsessive-compulsive) and 26 healthy volunteers. Their personality traits were measured using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). Compared with healthy subjects and other patient groups, the histrionic group scored higher on the basic traits Affective Instability, Stimulus Seeking, Rejection and Narcissism, and on the higher traits Emotional Dysregulation and Dissocial, than the other groups, and the schizoid group scored lower on most of the DAPP-BQ basic and higher traits. In addition, the histrionic group showed steeper amplitude/stimulus intensity function (ASF) slopes at three midline scalp electrodes than the healthy controls or the other patient groups. The ASF slopes were not correlated with any DAPP-BQ traits in the total sample of 217 subjects. However, the DAPP-BQ basic trait Rejection was positively correlated with the ASF slopes at all three electrode sites in the histrionic group. The increased intensity dependence of the auditory N1–P2 component might indicate that cerebral 5-HT neuronal activity is, on average, weak in the histrionic patients.

A hierarchical model of normal and abnormal personality up to seven factors

Despite general support for dimensional models of personality disorder, it is currently unclear which, and how many, dimensions a taxonomy of this kind should include. In an attempt to obtain an empirically-based, comprehensive, and usable structure of personality, three instruments – The Temperament and Character Inventory-Revised (TCI-R), the Personality Diagnostic Questionnaire-4+(PDQ-4+), and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) – were administered to 960 outpatients and their scales factor-analyzed following a bass ackwards approach. The resulting hierarchical structure was interpretable and replicable across gender and methods up to seven factors. This structure highlights coincidences among current dimensional models and clarifies their apparent divergences, and thus helps to delineate the unified taxonomy of normal and abnormal personality that the field requires.

Normal personality versus pathological personality: dimensional and predictive study

The present study aimed to replicate the previous relationship between the Zuckerman personality model and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) and to evaluate the contribution of the facets and factors from Zuckerman's new instrument Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) versus the old Zuckerman-Kuhlman Personality Questionnaire to the four clusters of the DAPP-BQ. The sample consisted of 443 subjects from the general population of both sexes. The ZKA-PQ dimensions predicted between 35 % and 61% of the DAPP-BQ cluster variance and facets between 54% and 63%. Local regression graphical analysis (LOESS) showed that neuroticism and aggressiveness are the dimensions most related with emotional dysregulation. Sensation seeking and aggressiveness were associated with dissocial behaviour. Neuroticism and extraversion (negative) were associated with social avoidance and activity and sensation seeking (negative) with compulsiveness. The new ZKA-PQ improves the psychometric properties of the old Zuckerman-Kuhlman Personality Questionnaire. Both dimensional personality measures can play a role in the prediction of the future DSM-V personality disorder dimensional system.

Relationship Between Intimate Partner Violence, Depressive Symptomatology, and Personality Traits

The aim of this study was to examine the relationship between intimate partner violence (IPV) and personality disorder symptoms controlling for depressive state. Victims of IPV (n = 176) and non-abused women (n = 193) completed the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), Index of Spouse Abuse (ISA), and Beck Depression Inventory-II (BDI-II). IPV victims scored higher than non-abused women on Intimacy Problems, and scored lower on Rejection traits, after adjustment for depressive symptoms. Severity of the IPV was related to Cognitive Distortion, Suspiciousness, Restricted Expression, and Intimacy Problems, and the length of the IPV was negatively associated with Rejection. The current study suggests only modest differences in personality traits between IPV and non-abused women. The DAPP-BQ traits associated with severity of IPV, in a dose-response manner, would partially reflect the symptoms of complex post-traumatic stress disorder (CPTSD), although this possibility deserves further study.

The role of co-morbid personality pathology in predicting self-reported aggression in patients with schizophrenia

BackgroundPersonality pathology affects behavioral patterns in patients with schizophrenia notwithstanding psychotic symptomatology. An investigation of the role of co-morbid personality pathology in the occurrence of aggression in schizophrenia is explored using both categorical and dimensional approaches to personality pathology. MethodsIn a cross-sectional study we evaluate, in 97 patients diagnosed with schizophrenia, the effect of personality pathology on the occurrence of aggression in schizophrenia using both a categorical approach, as described in DSM-IV-TR Axis II, and a dimensional approach, as operationalized in the Dimensional Assessment of Personality Pathology–Basic Questionnaire (DAPP-BQ). We also employ mediation analyses to explore the extent to which dimensions within the DAPP mediate the relationship between co-morbid personality disorders and aggression. ResultsPersonality pathology accounts for aggression in schizophrenia. Both the categorical and the dimensional approaches equally well account for the occurrence of aggression, with each model accounting for 60% of the variance. Interestingly, the mediation analysis reveals that the association between categorically defined personality pathology and aggression is substantially mediated by the higher-order-trait dissocial behavior of the DAPP-BQ, accounting for 50.6 % of the total effect size. ConclusionPersonality pathology can be a significant predictor of aggression in patients with schizophrenia. While both the categorical and the dimensional trait models of personality disorders equally explain the aggression data, much of the relationship between the categorically defined personality disorders and the occurrence of aggression in schizophrenia can be explained by the presence of dissocial behavior as operationalized in the DAPP-BQ dimensional model.

Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder

This pilot study was a comparison of dimensional models assessing personality traits and personality pathology in a clinical sample of adults diagnosed with ADHD and adults diagnosed with borderline personality disorder (BPD), and a nonclinical control sample of healthy adults. Personality traits were assessed using the NEO-Personality Inventory-Revised (NEO-PI-R) and dimensional personality pathology with the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). Adults with ADHD and BPD produced higher Emotional Dysregulation/Neuroticism and Dissocial Behavior scores than controls. For the Extraversion/Inhibitedness scale, adults with BPD produced significantly lower scores than adults with ADHD and controls. On the Conscientiousness/Compulsivity domains, Conscientiousness scores were lower for both disorders, whereas low Compulsivity values were specific to adult ADHD. Our results suggest that patients with adult ADHD and BPD have distinguishable profiles of personality traits and personality pathology.

Criterion-related validity of the DAPP-SF and its utility as a screener for personality disorders in outpatient care

There is a need in clinical practice for a concise measure to screen for personality pathology in patients seeking treatment for common mental disorders, such as mood or anxiety disorders. A shortened version of the Dimensional Assessment of Personality Pathology Basic Questionnaire (DAPP-BQ)—the DAPP-Short Form (DAPP-SF), comprising 136 items (6–10 items for each dimension), was tested on its criterion-related validity and ability to screen for personality disorders. Scores on the dimensions and the second-order factors of the instrument were compared for two samples: patients with personality disorders (N = 1 091) and a community-based sample (N = 478). The mean score of the two groups differed significantly on most of the scales of the DAPP-SF, a finding in support of the criterion-related validity of the instrument. Identity problems and the second-order factor emotional dysregulation were best suited to discriminate patients with personality disorders from the control group. Cut-off values with optimum sensitivity or optimum specificity for screening of personality disorders are presented for men and women separately. In the community sample, the proposed cut-off value suggests a prevalence of 13.8% for personality disorders. Applied to a sample of patients with mood, anxiety and somatoform disorders (N = 1 329), the proposed cut-off with optimum specificity suggests a prevalence of 45.6% of personality psychopathology in this sample. Copyright © 2010 John Wiley & Sons, Ltd.

A General Factor of Personality (GFP) in the Personality Disorders: Three Studies of the Dimensional Assessment of Personality Pathology — Basic Questionnaire (DAPP-BQ)

We used structural equation modeling to test the hypothesis that a General Factor of Personality (GFP) occupies the apex of the hierarchy of personality disorders in three validation samples of the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ). In a general population sample (N = 942), we found a GFP explained 34% of the variance in four first-order factors and 33% of the variance in all 18 scales. In a twin sample (N = 1,346), a GFP explained 35% of the variance in four first-order factors and 34% of the variance in all 18 scales. In a clinical sample (N = 656), a GFP explained 34% of the variance in four first-order factors and 30% of the variance in all 18 scales.

The Danish DAPP-BQ: Reliability, Factor Structure, and Convergence With SCID-II and IIP-C

The psychometric properties of the Danish version of the Dimensional Assessment of Personality Pathology-Basic questionnaire (DAPP-BQ) were assessed in both a clinical (N = 76) and a nonclinical sample (N = 168). Internal consistencies of all scales were adequate in both samples. The four factors labeled Emotional Dysregulation (ED), Dissocial behavior (DB), Inhibition (IH), and Compulsivity (CO) were fully replicated in the clinical sample but only partially replicated in the nonclinical sample. Congruency coefficients between samples ranged from .98 to .80. Convergent validity of the DAPP-BQ was tested by correlation analysis with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) and Inventory of Interpersonal Problems-Circumplex (IPP-C) scores. Relationship to the SCID-II was largely as predicted and in accordance with previous research. Correlations between DAPP-BQ higher order dimensions and IPP-C were also largely as hypothesized but also called attention to important conceptual issues including the fact that the higher-order term Emotional Dysregulation may not be an adequate label for a domain of behaviors that are highly interpersonal. Overall, the results indicate a successful translation of the DAPP-BQ and the strong association with interpersonal problems is regarded as an additional support for the content validity of the model.

Clinical Validity of the “Dimensional Assessment of Personality Pathology (DAPP)” for Psychiatric Patients With and Without a Personality Disorder Diagnosis

There is a movement towards a dimensional classification of personality disorders (PD). However, data linking dimensional systems and the categorical system for classifying PD are lacking. In the present study, N = 165 normal subjects and N = 222 nonpsychotic in-patients (including N = 81 patients with a PD diagnosis) completed the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) measuring 18 PD traits. DSM-IV PD symptoms were assessed by SCID-II interviews. Group differences were analyzed by ANCOVA, and the relation between the dimensional and categorical approach was investigated by regression, ROC, and MDS analyses. Patients with PD exhibited elevated scores on all DAPP traits compared with controls. Patients without PD scored in between. Each DSM-IV PD could be described by a distinct profile of DAPP traits. Results support the assumption that the DAPP trait system can represent mean differences between clinically defined subgroups. The categorical system can be mapped onto the dimensional DAPP system with sufficient clinical specificity.

Problemi di psicoterapia

- After an introduction on the dimensional approach in personality diagnosis and on its use as an attempt at solving some of the problems of categorical diagnoses (such as those of DSM-III and DSM-IV), the main dimensional models of personality are presented, namely: 16 PF Questionnaire by Cattell, Eysenck Personality Inventory (EPI), Five-Factor Model (FFM) by Costa & McCrae (Big Five), Temperament and Character Inventory (TCI) by Cloninger, Schedule for Nondaptive and Adaptive Personality (SNAP) by Clark, Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) by Livesley, Structural Analysis of Social Behavior (SASB) by Benjamin, the "fundamental polarity (anaclitic and introjective) of personality" by Blatt, Shedler-Westen Assessment Procedure (SWAP). Finally, advantages and disadvantages of dimensional models are discussed, with particular emphasis on borderline disorder.key words: personality, dimensional models, categorical model, borderline, diagnosis

Reliability and Validity of the Dutch Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF), A Shortened Version of the DAPP-Basic Questionnaire

The Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) appears to be a good choice for the assessment of personality pathology. However, due to its length, administration of the instrument is rather time-consuming, hindering standard inclusion of the DABB-BQ in a battery of assessment instruments at intake. We developed the 136-item DAPP-SF (Short Form), and investigated its psychometric characteristics in various samples, i.e., a community-based sample (n = 487), patients with mood-, anxiety-, and somatoform disorders (n = 1,329), and patients with personality disorders (n = 1,393). Results revealed high internal consistency for almost all dimensions. The factor structure appeared almost identical as compared to the factor structure of the original DAPP-BQ, and was shown to be invariant across the various patient and community samples. Indices for convergent, discriminant and criterion related validity were satisfactory. It is concluded that the good psychometric characteristics of the original DAPP-BQ were preserved in the shortened version of the instrument.

Pathological personality traits and externalizing behaviour

AbstractPrevious research has identified general personality traits and personality disorders that are associated with externalizing behaviour (EB). There is a dearth of research, however, investigating the relations between pathological personality traits and EB. The current study examined pathological personality traits, as measured by the Schedule for Non‐adaptive and Adaptive Functioning (SNAP) and the Dimensional Assessment of Personality Pathology‐Basic Questionnaire (DAPP‐BQ), in relation to EB. Undergraduates (n = 228) completed the SNAP, DAPP‐BQ, and a measure of antisocial behaviour, substance use, gambling, intimate partner violence and risky sexual behaviour. Using confirmatory factor analysis, we identified the best fitting model as one that specified eight factors: five personality factors composed of constructs assessed by the DAPP and SNAP, one externalizing factor and two method factors corresponding to each of the measures. Consistent with the empirical literature using general personality traits, the current results suggest that pathological personality traits related to impulse control (i.e. low conscientiousness), as well as more interpersonally focused traits (i.e. low agreeableness), were most strongly associated with EB. Copyright © 2009 John Wiley & Sons, Ltd.

Structure of Personality Pathology in Normal and Clinical Samples: Spanish Validation of the DAPP-BQ

Given that the DSM taxonomy of personality disorders is flawed by severe classificatory problems, the development of alternative classificatory systems, such as the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), has now become a priority. This study examined the internal consistency, second-order factor structure, and criterion validity of a Spanish translation of the DAPP-BQ in two samples: subjects with personality disorder (n = 155) and subjects from the general population (n = 300). Alpha coefficients ranged satisfactorily from .75 to .93. Four second-order factors of Emotional Dysregulation, Dissocial Behavior, Inhibitedness, and Compulsivity were obtained, which were replicable between samples and identical to those reported in the literature. Finally, disordered subjects scored significantly higher than normal subjects on 17 of the 18 DAPP-BQ traits. Some pending issues in the construction of an alternative taxonomy of personality disorders are discussed.

A short form of the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ): The DAPP-SF

A short form of the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), called the DAPP-SF, is presented, consisting of 136 of the original 290 items. It was established in a community sample that the factor structure of the DAPP-SF is highly congruent with the structure of the DAPP-BQ. The 18 DAPP-SF scales, which were found to be highly reliable, turned out to correlate substantially with the DAPP-BQ scales, even after applying a necessary correction, as the DAPP-SF was developed in the same sample used to investigate the Dutch DAPP-BQ. The higher-order convergent validity of the DAPP-SF was demonstrated by correlating the DAPP-SF scales and factors with Van Kampen's 5DPT. The same factor structure as found in the community sample of patients with personality disorder, also demonstrating that the agreement between the DAPP-SF and the DAPP-BQ is not dependent on the use of shared data. Finally, following Bagge and Trull [Bagge, C.L., Trull, T.J., 2003. DAPP-BQ: Factor structure and relations to personality disorder symptoms in a non-clinical sample. Journal of Personality Disorders 17, 19–32], specific predictions were tested concerning differences in means on the 18 scales between 10 diagnostic groups in the sample of patients with personality disorder. Results supported the validity of the DAPP-SF with respect to its lower-order structure. Finally, for practical purposes, preliminary norms are presented for females and males from the community in two different age groups.

Dimensional Assessment of Personality Pathology in Female and Male Juvenile Delinquents

A developmental perspective implies similar personality pathology dimensions for adolescents and adults. The present study examined the applicability of a dimensional approach in incarcerated delinquent female and male juveniles using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). A sample of detained adolescents (n = 146) was compared to adolescent students (n = 98) and a healthy control group of adults (n = 82). Additionally, psychopathology was assessed in the incarcerated juveniles using the Youth Self Report (YSR). Analyses of variance revealed higher scores on personality disorder traits for juveniles compared to adult controls; the highest scores were observed in criminal juveniles. Hypothesized relationships could be confirmed within the criminal sample between the DAPP factor Emotional Dysregulation and the YSR Internalization syndrome scale, and between the DAPP factor Dissocial Behavior and the YSR Externalization syndrome scale. Moreover, gender differences in the criminal sample are discussed. Results indicate that the DAPP-BQ can assess personality disorder traits in delinquent and nondetained juveniles with sufficient group and criterion validity.